Non-Hormonal Birth Control: What Are My Options?

When women think about birth control, the go-to option is usually the birth control pill. Often prescribed at a young age, many women are on the pill for most of their lives, up until they want to have a baby, and then sometimes straight after they give birth again. There's a good reason of course. Not only is it an easy form of birth control, the pill, when taken perfectly, is 99% effective. But despite the popularity and effectiveness of the pill, hormonal birth control is not for everyone. Many women are starting to get clued up on the side effects of hormonal birth control. The obvious reason to stop taking the pill is if you want to have a baby, but more and more women are quitting the pill to return to a natural cycle. 

If that’s you, then you might be wondering about other, non-hormonal birth control options. If you’re exploring your options, there are a few hormone-free options to learn about. Each one has pros and cons so what you decide to use will be a personal choice. Consider your main goal: is it preventing pregnancy or something else? And consider how comfortable you are with risks and side-effects as the effectiveness of each option is different. 

And if you’ve recently quit taking the pill, check out our post on how to get your cycle back on track. 

Perfect Use vs. Typical Use 

Before we get into the details of each option, it’s important to understand the difference between “perfect use” and “typical use.” Perfect use means using the method exactly as directed every single time you have sex. This can be a hard standard to maintain, even for the most meticulous women out there, so it’s also important to also understand the meaning of  “typical use.” This refers to the way most people use birth control which means there may be times when you don’t use your birth control method at all or you use it incorrectly. Mistakes happen. We get it. But the rate of pregnancy changes depending on perfect use or typical use, so be aware. 

Non-Penetrative Sex 

The first option might seem too basic but have you considered simply not having penetrative sex? This could involve kissing, masturbating together, using vibrators or sex toys. Some women say these things are just as exciting as sex and sometimes even better! 

It could also include things like watching porn with your partner, massaging, or anything else that doesn’t involve inserting things into your vagina. 

When used perfectly, these forms of sexual activity prevent pregnancy but typical use sometimes “accidentally” leads to penetrative sex. You can get caught up in the moment, we know! In that case, pregnancy can happen if you’re not using another form of birth control.

Withdrawal

The withdrawal method probably sounds a lot fancier than it is. It’s also more commonly known as “pulling out.” Basically, you have your partner take his penis out of your vagina and ejaculate somewhere else to try to prevent pregnancy. The goal is to stop sperm from going into your vagina. 

It all sounds simple enough, right? But when you’re in the moment, mistakes happen. It can require practice and some men have trouble pulling out when they are close to orgasm. That’s why this method is often most effective when it is used with another form of contraception. On its own, when done perfectly, it’s about 80% effective. In some cases, there are some sperm cells detected in precum (also known as pre-ejaculte or pre-ejaculatory fluid). This is a clear fluid released from the penis after an erection but before ejaculation. This is something to be aware of because it can increase the chances of pregnancy happening accidentally if you use the withdrawal method. 

Sensiplan / Natural Family Planning 

Sensiplan is a form of natural family planning that uses your menstrual cycle to predict ovulation and the days that sex could result in a pregnancy. If you don’t want a baby, you can avoid sex on the days you’re ovulating (or use another method of birth control). In order for this method to work, you need to understand and track your cycle. If you have a regular cycle and you’re tracking things using an app like Natural Cycles, fertility-awareness based methods of birth control can be effective. But this is also a method that is prone to human error. Typical use of this method has anywhere from a 12-23% chance of pregnancy so be aware. With perfect use, Sensiplan is 99.6% - 98.2% effective

If this is something you would like to try, we recommend tracking your cycle using an app (like the ones listed here). 

External Condom

The condom is probably the most common and popular form of non-hormonal birth control. Latex, plastic or lambskin condoms are the most common kinds of condoms. When used perfectly (ie: exactly as directed every time), they are very effective at preventing pregnancy. In fact, perfect use of condoms only has a 2% chance of resulting in a pregnancy. They’re easy to find in most pharmacies or supermarkets and they’re relatively inexpensive. Sometimes, you can even buy them in vending machines in bars or rest stations! Hey, when the mood strikes, right? They also come in a huge variety of colours, shapes, sizes and textures so there’s something for everyone. Adding a form of lube can make sex with a condom more comfortable, but make sure you pick a lube that doesn’t impact the effectiveness of the condom. Water or silicone-based lubes are usually best. 

Internal Condom

Internal condoms are an alternative to regular condoms worn by the woman. They provide pretty much the same great contraceptive protection from pregnancy and STDs as a regular condom and they are pretty easy to use - with a little practice! You can even put it in up to 8 hours before having sex. They prevent pregnancy by covering the inside of the vagina and collecting semen. If used perfectly, internal (or female) condoms are about 95% effective. 

Diaphragm

A contraceptive diaphragm or cap is a circular dome made of thin, soft silicone that's inserted into the vagina before sex. It covers the cervix so sperm cannot get into the uterus to fertilize an egg. You need to use a diaphragm with spermicide and it needs to be left in place for 6 hours after having sex. If this is something you want to try, you need to have your first diaphragm fitted by a gynecologist as everyone will require a different size. And if you lose or gain weight, you may need to be fitted with a new one. 

This form of contraception comes with a little more effort, but it is effective and hormone-free! If you use your diaphragm perfectly every single time you have sex, it's 94% effective. But nobody's perfect, so in real life diaphragms are about 87% effective — that means about 13 out of 100 people who use a diaphragm will get pregnant each year.

Creams, Foams and Suppositories

There’s a whole variety of spermicides available in different formats: creams, foams and suppositories. While they’re often used with other methods like diaphragms or condoms, they can be used on their own. Each kind will be a bit different in the way you use it, but basically, you will apply the spermicide close to your cervix. Depending on the format you choose, it could be with an applicator (similar to a tampon applicator, a suppository tablet or a cream that you insert into the vagina as far as possible. Spermicides slow down sperm and stop it from entering into the cervix where it might come in contact with an egg. 

As you can probably tell, the effectiveness rates of these methods are not as high as others. Unintended pregnancy in one year of use was about 21% with typical use (16% with perfect use). 

Copper IUD 

IUDs or intrauterine devices are very effective forms of birth control. In fact, they are about 99% effective when they are placed correctly by a healthcare professional. Also, they are the lowest maintenance form of birth control out there. Once it’s inserted, job done. You don’t need to worry about it. 

There are two types of IUDs: the copper IUD and a hormonal version. We’re talking about the copper IUD in this post. It’s a small T-shaped device that stays in your uterus anywhere from 3-10 years, depending on the kind you get. It works by sending out copper ions that make it difficult for sperm to move and reach an egg. 

The only downside is that it’s not something you can remove by yourself. If you decide you want to try for a baby, you need to have a doctor remove it. It can also be a bit of an uncomfortable procedure to have it inserted, but most women say it’s no big deal. This can be a great form of birth control if you are not planning to have a baby any time soon (or at all) or if you’re someone who routinely forgets to take their pill! 

Sterilization

This method is a more serious route to take, but it offers incredible effectiveness. In women, we're talking about closing off those fallopian tubes (also known as tubal occlusion), while in men, it's the vas deferens that gets the snip (aka vasectomy). By doing so, these procedures ensure that those sneaky little swimmers, AKA sperm, can't reach their target: the egg.

Sterilization is a big decision because it's permanent. Yep, no turning back. So, before you go down this path, it's crucial to be absolutely certain that you no longer want to have children. It's not a choice to be taken lightly!

Talk to One of Our Experts

Still not sure what form of birth control is right for you? Talk to our experts. Everyone is different and we can help you figure out the best birth control for you.